Monthly Archives: May 2013

Lean Development Excellence Featured Product: Smartphone Physicals

A Lean Development is ultimately a disruptive innovation, which means it dramatically changes an industry, effects all consumers, and generates new product families.

In this blog post, I’ll examine a remarkable way that smartphones are being adapted for use in medicine in ways that optimize value for the patient, and drive out wastes from the healthcare system.SmartPhone Physical

Ever imagine that your smartphone would take your blood pressure from the comfort of your home?

Or can you envision getting your blood sugar readings instantaneously on your iPhone?

Have you ever thought that your doctor would do an ECG or ultrasound on an iPhone right in his or her office?

It sounds like an instrument that Dr. Bones would use in Star Trek from his medical room on the Enterprise.  But that science fiction is now becoming a reality.  The future is here today!  These things are being done today, and will become common place in a few years.

“How long will it be before we’re all having our own smartphone physicals every one or two years?  Devices such as the body analysis scale, blood pressure cuff, pulse oximeter, and ECG are already in use as teaching devices in med schools and by some patients, and some early adopting clinicians are using them in daily life. TEDMED speaker Eric Topol has been integrating smartphone-based devices into his practice over the last few years and most recently used his AliveCor to diagnose a passenger-in-distress on an airplane as well as the CellScope Oto to visualize Stephen Colbert’s ear drum on the “Colbert Report.”  See TEDMED

SmartPhones are bringing new value to medicine.   The Smartphone used in this way brings new frontiers to the doctor patient interaction.   Here are the values that are optimized:

  • Tests can be done immediately.
  • The results are accurate.
  • The doctor’s diagnosis can occur in nearly real time.
  • Instant readings can help save lives.
  • The patients data can be saved for future comparisons and progress.
  • The patient can own their own improvement program with instant and continuous feedback on  progress

According to Eric Topol, a pioneer in the field of smartphones used in medicine, this new technology will disrupt the health care system and drive out wastes.     Smartphones used in this way will help to reduce unnecessary tests, or bring the tests directly to the patient.    Medicine can become personalized, and there will not be a need to do mass screenings.     Furthermore, drugs can be properly and accurately prescribed based on real-time data from the patient.  Here are the wastes that are driven out of the healthcare system:

  • Costly procedures are replaced by a low-cost or no-added-cost procedure
  • Patients no longer need to travel to the tests, the tests go to the patient
  • Medications can be calibrated based on the needs of the body
  • Mass screenings can be replaced by targeted tests for the individual

As more of these devices are available and more and more tests are possible from the smartphone, your next physical very well might be a smart phone physical.   The result will be a more thorough physical, with more test and feedback given directly to you as the patient.  And the costs of the tests will be lower, if not eliminated completely.

So, enter the brave new world of Lean Development, where disruptive innovations bring new value and eliminate wastes.

SmartPhone Pulse


Lean development for Florida Wesley Chapel Hospital


Lean development is credited in another hospital design.  This one is Florida’s Wesley Chapel.

“The team relied on research and lean principles to address design of the patient rooms, patient units, emergency department, clinical laboratory, surgery, and sterile processing, with special attention paid to work flow, adjacencies, optimization of staff time, and functional tasks. Throughout the facility, large windows offer natural light and views, while multiple gardens provide spaces for family, patient, and staff respite.

The greenfield site itself posed particular challenges since one-third was deeded wetlands. Florida’s wetlands preservation laws required multiple reviews with many government agencies. HuntonBrady worked with the civil engineer to create a three-phase site plan to demonstrate how the hospital could grow and make best use of the site, while minimizing impact on current operations. For this reason, departments most likely to expand are on the first level and have exterior walls.”







Waste Prevention

Annual Health Physical: Lean by design


I recently attended my annual check-up and physical by my primary care doctor.   A number of things seemed different this year.   My doctor knows me quite well, and he knows about my professional interest in LEAN.  So he was excited to talk about what has changed.  My experience as a patient was completely different this year, accelerated by a grant to implement LEAN in his office.   If you are a health professional and want to delight your patients, take this piece of advice.  Go Lean.

So, what did the experience look and feel like for the patient after the implementation of Lean?  From the minute I walked in the door, I experienced many improvements.

1. No delays or queue.

There was no waiting at the front desk.   All of my records are now on the new EMR (Electronic Medial Records) system.   No copies were needed of my insurance card.  No questionnaires to fill out.   Only one quick form to sign for HIPAA.

2. No waiting once checked in.

I sat down in the waiting room, expecting to wait for a few minutes.   I had just signed my HIPAA form and was preparing to bring it to the front window, when the nurse called me in, “Timothy?”   At first, it didn’t register.

“Timothy?” she called again.

“Ah, was that Timothy you called?”, I replied.

“Yes,  Is that you?”

“Ah …Yes. I still have the form they asked me to sign.”

“No problem she said, I’ll take it.”

No wait time.  No division of duties.  Pretty smooth so far.

3.  Improved Flow

I noticed that the flow path to the room had improved.  Now the scale and height gauge were right on the way to the room.   “Umm, do I need to take off my shoes?”   “No it’s fine” said the nurse, ” We just need an idea of your approximate current weight.  It’s up to you.”  (No over-processing here.)

Well, I did take them off knowing that I had put on a few pounds since my last visit.  (1o pounds to be exact – It’s been a long winter in Michigan).

4.  Work area ready for the patient (5S)

On the way to the room…. the nurse stopped…there were 2 rooms to choose from.  She had to decide where to put me!  Obivously there is good flow in this office I thought to myself.  No waiting for a room.  The room was ready and everything was laid out for the physical.

5.  Excellent training and standard work

She went through the regular questions.  Everything was on their new computer system.   No paper records, only electronic records.  Very well done I thought.

She took a little time with the system (just a few seconds) and apologized since she was new.  “How new?”, I asked.   “Oh, I just started on Monday.”  Well, obviously they had standardized the work and training for her, because she was very efficient.  She then took my blood pressure, pulse, temperature, etc.   Everything went into the computer.   Then she said, “The doctor will be right in.”     So I picked up my smartphone to check my email, and before I had a chance to read one e-mail, I heard the doctor outside the room.   Then a slight knock, and there he was.  Wow… No waiting for the doctor.

6.  No rework

The doctor already had all of my information in his computer.   Everything done so far; my weight, my blood pressure, the questions I had answered, etc. ….they were all on his screen.

7.  Connected to Suppliers

When I asked my doctor for a refill on my prescription.   He said with a smile… “This is the part I love!”   He clicked a few buttons, and said, “There… it is sent to your pharmacy.”    Literally in a matter of seconds my prescription was sent to the pharmacy.

8.  Focus on the customer

My doctor spent nearly the whole visit dealing with me.  He went over everything connected to my health.  My family life, my exercise routine, my diet, yes… even my sex life.

9.  No waste

As the visit neared the end.  He said, “we are trying something new.”   Your billing is all handled in the room.   So after he left, a member of the office staff came in immediately to the room and went over the final bill and co-pays.   Everything was completed in a few seconds, and I was free to go.

10.  Total customer experience across the value stream.

I had to know… was my prescription really ready?  Will the pharmacy be as efficient?  So I went directly to the pharmacy after the appointment.  And yes.   The pharmacist had the prescription waiting for me.  And when he saw me come in, he brought my prescription to the front counter.  I was in and out of the pharmacy in a matter of 5 minutes.

So LEAN in Healthcare can make a huge difference in patient experience.   Congratulations to Dr. Terrence Wright and the staff of his office.